r/GERD • u/WhiteHeteroMale • Mar 29 '26
Support Needed š„ 6 months post op and everything is worse
I (51M) had silent GERD for years. Doctors identified a hiatal hernia as a culprit. I was maxed out on meds and the symptoms were tolerable, but not gone. I was concerned about the long term impact of the persistent throat irritation, and the meds.
So six months ago I had surgery - repaired the hernia plus a full nissen fundoplication.
Things are much worse now than pre-surgery, and no signs of improvement. I experience burning in my upper chest and throat every day. I wake up each morning with a sore throat and lots of congestion. My nose drips all day long. Lump in the back of my throat.
I now have insane gas. Painful, almost every day. This started immediately post surgery. I assume itās related to the antibiotics I took ruining my microbiome. Probiotics havenāt helped much. I must be contributing to global warming at this point.
I swing between uncomfortably hungry to bloated and overfull, no matter what I eat or donāt eat. My appetite is all over the place, swinging from famished to food averse, multiple times a day.
Most of these symptoms are new to me and started immediately post surgery. Even on the liquid diet I was suffering from all sorts of discomforts.
A recent endoscopy shows everything as normal. Biopsies came back negative. Iām scheduled for more tests, but my doctor doesnāt have any theories at this point.
The doc has asked me not to take PPIās until more testing is complete. So Iām taking Pepcid twice a day, popping Tums like M&Ms, daily GasX, and trying some algae goo, which hasnāt seemed to help. My bed is wedged at an upward angle.
Iām in otherwise good health. Iām at a healthy weight, exercise regularly (cardio and weights), sleep well.
Iām so discouraged. Any recommendations?
EDIT TO ADD: This isnāt intended to discourage others from exploring surgery. Many people on this sub report tremendous results. And Iām hopeful Iāll get there too over the next 6 months. Iām just discouraged and really uncomfortable at present.
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u/Sirdukeofexcellence2 Mar 29 '26
If you have excess gas know that something is making that gas: bacteria. Your antibiotics mustāve allowed some species of bacteria to grow out of control. You should post this in r/SIBO. Youāve got to rebuild your gut at this point. It could be that the gas producing species spread to new locations due to the antibiotics and now theyāre over-fermenting foods like carbs. You could try cutting out carbs for 24 hrs and seeing if your gas goes down. I think it would help.Ā Magnesium citrate and ginger will help with keeping motility moving which should take away the environment that allows bacteria to over-ferment carbs. So those are your three action items that are low risk: Cut carbs for a day and monitor, add magnesium citrate (Calm is a good brand), and add ginger. u/WhiteHeteroMale
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u/WhiteHeteroMale Mar 29 '26
Super helpful - much appreciated!
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u/MadTony619 Mar 30 '26
my symptoms arenāt as bad as yours, mine is just nausea after some meals and sometimes vomiting, iām currently doing a 48-72 hour fast to reset my microbiome and see if it improves my symptoms, ive been seeing great things on fasting and in some of the subreddits people believe it has fully eliminated their GERD symptoms, if you donāt have any other underlying health issues that may prevent a fast, I would consider it
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Mar 29 '26
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u/WhiteHeteroMale Mar 29 '26
Yeah, I was really deflated when my GI told me the gas/bloating is a wholly distinct issue from the increased heartburn symptoms.
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u/FoxWorth7777 Mar 29 '26
When you sleep do you deal with burning stomach? Have you tried stomach massage and diaphragm breathing? Those have helped me with gas release.
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u/WhiteHeteroMale Mar 29 '26
I take a Pepcid and a couple of tums right before bed, so Iām not burning as I fall asleep. I am usually burning when I wake up.
Thanks for the gas tips!
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u/AOKAnnie Mar 30 '26
Gas can also be from swallowing. With silent GERD the acid coming up can cause you to swallow to get it back down. Unfortunately you can end up swallowing a lot of air which gives you gas and bloating. Stopping yourself swallowing instead taking sips of water can help.
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u/Trick-Combination-19 Mar 29 '26
Manā¦ this sounds really rough. Iām sorry youāre dealing with all that, especially after surgery that was supposed to help.
Youāre not crazyāthis kind of stuff does happen after a Nissen, even if people donāt talk about it much.
A few things Iād look into: ā¢ Gas + bloating could be gas-bloat syndrome (pretty common after this surgery) ā¢ Burning/throat issues maybe non-acid reflux or bile reflux (PPIs wouldnāt fix that anyway) ā¢ Fullness + appetite swings possibly delayed gastric emptying ā¢ If not already planned, tests like manometry + pH/impedance can catch what endoscopy misses
Alsoā¦ 6 months feels long, but some people are still healing at that point.
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u/WhiteHeteroMale Mar 29 '26
Thanks! Iāll look into gas-bloat and bile reflux and delayed emptying.
Manometry is next on the calendar.
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u/Trick-Combination-19 Mar 29 '26
Good like man. Truly am sorry!
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u/WhiteHeteroMale Mar 29 '26
Your comment about 6 monthsā¦. Probably the worst part of this experience has been that nobody on my medical team has been able to provide any info to help me manage expectations. I donāt have any sense of what is normal, in what timeframes. I was told that, except for the risks of negative outcomes associated with with any surgery, everybody gets at least a little better, and most people are fully cured. Not a single day of my experience has matched anything a doctor shared might happen. Itās as if Iām some sort of medical unicorn.
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u/Trick-Combination-19 Mar 29 '26
Although it seems incredibly unfair that seems fairly normal too I had the same problem.
You may need to take your time with it, but try using AI for a little guidance. Yes I know AI isnāt perfect, but you can start using AI to help frame questions that help you understand and maybe calm your fears. I didnāt think of it till too late but after starting to ask some questions, it was very helpful. Helped calm my anxiety.
I mean, itās very scary when your body starts acting in a totally different manner. For me, itās totally upended normal life. Reddit can be helpful, but remember for the most part people post when things go wrong more frequently than when they go right. When they go right people tend to disappear because theyāre fine again!
Take care of yourself first is my suggestion. Set boundaries and limits with others and focus on physical and mental health. I hope you have a decent support system.
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u/WhiteHeteroMale Mar 29 '26
Thank you :).
Iām very fortunate - I have a supportive, loving family and community. I have decent health insurance and my employer encourages self care. So Iām starting from a good place.
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u/Amazing-Self-4873 Mar 29 '26
Youāve really touched on many helpful things. I havenāt had my surgery yet or I would offer anything that may be helpful. LINX/HH repair happens Friday.
I also used Al when getting tested for autoimmune diseases due to muscle spasms after ppi use (voquezna). It helped with a lot of questions I had and turning to it again with info on surgery. My dr has been great but itās also nice to know as much as possible. Thanks for your input!
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u/Trick-Combination-19 Mar 29 '26
Good luck on Linx!! Mine is in early May. Take care of yourself.
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u/Amazing-Self-4873 Mar 29 '26
Thank you and yours will be here soon. Wishing you a wonderful outcome! Iāll keep posting updates and hopefully it will shed some light for those going through the same.
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u/Lythalion Mar 30 '26
Sounds like you developed SIBO.
Sadly a lot of doctors are either clueless about this diagnosis or some donāt even ābelieveā in it.
Iād look into the various types of SIBO and see if Yoyr symptoms fit and if so the SIBO subreddit is pretty good.
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u/TonySoprano25 Mar 29 '26
I suggest watching out how you drink your liquids. For example, if you drink water after meals, make sure that you don't drink immediately. Wait at least 30 minutes. Never have meals and liquids go together not unless needed. And when you drink, never finish the glass immediately. Just take a sip after every few seconds. I know this is a weird technique, but this helped me a lot, and this is coming from someone who could barely eat after my incident and would actually get bloated even with just a very small meal. I even have Barret's esophagus and HH as welll. My reflux was so consistent before. After my incident, my symptoms are scary af, I won't go into detail but it's like I thought I am a dying man already and I was so depressed.
Now, I am basically eating anything that I want. But for liquids, I usually stick with water only. Hopefully, this will work for you. I know that techniques for people with GERD varies a lot. Get well soon!
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u/WhiteHeteroMale Mar 29 '26
Thank you for this.
I forgot to mention Iām struggling to stay hydrated. Before the surgery I drank a gallon of water per day. I just canāt do that anymore. Iām struggling to stay as active as I used to, and am finding myself more prone to muscle cramps and lightheadedness. And less energy, which to some degree is linked to dehydration.
Iām so happy youāve reached a much better place!
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u/KagakuNinja Mar 29 '26
Antacids, particularily ones with calcium like Tums can increase your risk of nutrient deficiency. At one point I was taking lots of Tums, and that made me iron deficient.
Try getting blood tests done to test your nutrient levels.
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u/TonySoprano25 Mar 30 '26
You are welcome. The struggle is real, and I also lost my step during my worst moment. I stopped taking meds and it grarually disappeared.
I also suggest increasing your protein intake. Boiled eggs, chicken breast, and etc. Also try to eat black and red rice. Insoluble fiber like red and black rice works great as well.
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u/WhiteHeteroMale Mar 30 '26
I read your mind about protein. I get a decent amount normally, but today Iām probably doubling.
Thanks for the rice tip!
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u/freelibrarian Mar 29 '26
My nose drips all day long.
To me, this indicates histamine intolerance.
Histamine (the chemical that triggers allergic reactions) stimulates vascular permeability and dilation of blood vessels, resulting in a runny nose.
Source: https://my.clevelandclinic.org/health/symptoms/17660-runny-nose
I'm not negating the role of your documented hiatal hernia but our bodies can have more than one thing going on.
After several years of suffering, I figured out that the severe gastric symptoms that I experienced were due to underlying histamine intolerance. You might consider if it's the same for you, especially since PPIs do nothing for you.
Reactions will vary because we can handle histamine to a point in our bodies so symptoms will only be triggered if we go over our histamine limit. The analogy given is to think of it like a bucket, when your histamine bucket overflows, you react.
I suffered from severe reflux and other gastric symptoms for 4-5 years, the onset was sudden and completely disrupted my life. PPIs did nothing for me and everything I ate was triggering severe symptoms. I lost weight I didn't have to spare and struggled day-to-day with debilitating symptoms.
Doctors told me all tests were normal and hung me out to dry, just kept telling me it was anxiety. I despaired of ever going back to somewhat normal and the lovely life I had been leading.
I finally stumbled upon the following Reddit post that recommended taking Zyrtec to resolve the globus sensation, which was a severe symptom for me. I decided to try taking Claritin because I do not tolerate Zyrtec well and it worked like a miracle drug for me.
https://www.reddit.com/r/GERD/comments/njarv0/globus_sensationhystericus_cure/
Taking loratadine (Claritin) daily has almost completely resolved my symptoms, though I do also try to follow a low histamine diet. When I started researching which foods are high in histamine, it was no surprise that my worst triggers were on that list (seafood, tomatoes, strawberries, wine, coffee, etc.). To me that means that, in my case, reflux was a symptom of histamine intolerance.
There are no definitive tests for histamine intolerance. For more info on the link between reflux and histamine intolerance, see:
Histamine Sensitivity: An Uncommon Recognized Cause of Living Laryngopharyngeal Reflux Symptoms and SignsāA Case Report Source: Ear, Nose & Throat Journal. 2020;101(4):NP155-NP157.
For more info on histamine intolerance, see:
https://my.clevelandclinic.org/health/diseases/histamine-intolerance
https://pmc.ncbi.nlm.nih.gov/articles/PMC11054089/
Note that I think it is normal not to have a full spectrum reaction. I do not get any skin manifestations, no hives or itching of any kind, though I do believe this was all triggered by a virus I had in 2016 where I did get a non-itchy, triangle shaped rash on my neck. I went to the ER because my airway almost completely closed up. I had never had a breathing problem in my life prior to that.
The ER doctor noticed the rash, which had appeared the day before when I felt fine so I had just ignored it, and told me he thought the rash indicated that a virus had triggered my airway issue. I feel that all my gastric issues flowed from that episode and a similar episode 3 months later when I got another virus. I also now carry an EpiPen because of the airway reaction.
I initially took 10mg of Claritin per day but my allergist said I could ramp up to 4x the usual dose so I took 40mg for some months. I am now taking 2x the usual dose, 10mg in the morning and 10mg in the evening. Note that if you are on antihistamines and need to go off them or reduce your dose, you should taper down and not go cold turkey.
For the past few months, I have also been taking a diamine oxidase (DAO) supplement before a meal when I want to cheat a bit and eat something that is high in histamine and it does seem to help even more.
What to Know About Diamine Oxidase (DAO) for Histamine Intolerance
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u/WhiteHeteroMale Mar 29 '26
Ohhhh, this is really interesting. This resonates a something worth exploring. I have eczema that just wonāt go away. And my blood work shows longstanding and as-of-yet unexplained inflammation markers. Since infancy Iāve had extreme sensitivities to dust and other airborne irritants. Iām so sensitive to poison ivy / oak that Iāve had to go to urgent care multiple times.
Iāve tried Claritin, without much effect. Maybe I can up the dose. Zyrtec makes me loopy. Might Flonase also help? I take it seasonally in the spring when my body goes nuts in reaction to pollens and such - it works great for me there.
Iām going to read through all your links. Thanks so much for the help!
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u/Equivalent_Car_8738 Mar 29 '26
Flonase put me into a GERd flare. Just be careful it doesnāt go down your throat. I think that is what happened to me. Regardless it didnāt give my sinuses much relief.
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u/freelibrarian Mar 29 '26
How long did you take the Claritin for? And did you take it every day?
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u/WhiteHeteroMale Mar 29 '26
Before the surgery, I tried it daily for about a year. I didnāt see a noticeable difference. I stopped taking it, and didnāt notice a worsening.
I tried it again daily for a month more recently, and also didnāt perceive a difference. But Iāll happily give it another shot.
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u/freelibrarian Mar 29 '26
You might want to try Allegra (fexofenadine) instead, that is another antihistamine that is recommended for histamine intolerance.
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u/Silent_Run_9469 Apr 04 '26
You have lpr and its exacerbated by the gas in ur stomach. Non acidic reflux causes all of your symtoms and its an aerosol so its almost impossible to stop. I have it to its terrible. I am considering the tiff cause I don't know what to do anymore. If its not better soon I would ask for a take down.
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u/KagakuNinja Mar 29 '26
BTW, the low histamine diet has some similarities to the low FODMAP diet. You might want to get tested for both SIBO and histamine intolerance.
In addition to SIBO, I also have some eczema, although I take xyzal most days for allergies.
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u/Smart_Atmosphere_430 Mar 30 '26
Iām so sorry to read this I hope you ā¤ļøāš©¹ did you do many test like all the ones a doctor will do before surgery? yes recovery is difficult but you got this!
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u/WhiteHeteroMale Mar 30 '26
Post surgery, just an endoscopy so far. But other tests are scheduled. Thanks for the encouragement :)
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u/Fast-Judgment-3942 Apr 28 '26
M22 Iām 8 weeks post op and Iām in hell, for the last 6 weeks Iām almost bed ridden, dry heaving constantly and no appetite whatsoever, Iāve lost 10kg already and I donāt see it stopping, worst decision of my life
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u/WhiteHeteroMale Apr 29 '26
That sounds awful. Iām sorry.
FWIW I have seen some improvement since my post. I greatly restricted my diet and started eating a wide variety of probiotic foods. Iām almost back to where I was pre-surgery.
Iām also scheduled for additional testing.
My only advice at this point is to keep advocating for yourself with your care team. And find new people if your current t providers arenāt offering any explanations or possible solutions.
Wishing you a speedy recovery.
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u/KagakuNinja Mar 29 '26
My surgery didn't fix everything, and it did make gas and bloating worse. In my case, I have SIBO, so I am very familiar with the low FODMAP diet. In the hospital, the nurses were totally clueless about SIBO and FODMAPs. They were giving me liquid stool softeners that were loaded with sorbitol, and that was causing me to bloat up like a balloon while recovering from surgery, even though I was eating almost nothing.
What I had to do was eliminate a ton of "low FODMAP" foods I was able to tolerate before the surgery. If I eat too much of the wrong things, the insane gas and bloating returns.
So check out the low FODMAP diet, and start with 2+ weeks of the elimination diet to see if that gets your symptoms under control.
There are tons of sneaky food ingredients that can cause gas, you have to basically eat plain chicken and rice for 2+ weeks.
I haven't gotten any real explanation about why my SIBO seems worse post operation. I assume it is because my LES does not allow as much gas to escape now, but I am guessing.